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ELEC�ICAL PERMIT AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - w't.�� �.� -� �'�: �*"= :•��z � J�9 :; <br />�;�t.��i �' !_vc=�C�i•{� v5 �.iJ c;Vi��Gf-�' ifJ:/-.�j;i�� <br />�� <br />u°UZ P, Nc <br />PROJECT ADDRESS <br />��fFl po r.��C I �j�l <br />�1'1f1^_f <br />�:��.��.,�)'J�r w' l,,�r"'i <br />Tenant <br />Atail ACdres; <br />:'an aad: e>s <br />I���:��'�1:11= ���.��IL �b i:V % ��1 <br />EleciricalContrac�oi t�a:itiadre;; <br />i�'-' �p��.�r Z 3�'t ��1 <br />Slatz License Number (required) <br />j i'J�1:�✓�li.r'Y�5 <br />i, Propcsed Use ol Bu�lding <br />City <br />ap. <br />�l 1°iLt��.,� <br />Gty. <br />Square Footage (B residenbal ne��i construction, remodel or addition) <br />�umber of devices (If Iori voltage) <br />�� � LO I <br />L i� l <br />Statc/Zip <br />StalelZip <br />�. <br />�A. �� U � i.� S <br />StatclZip <br />o����i <br />Phone <br />P��ne <br />11`1�1Z ZoiZ- <br />Pnorc <br />Ci;y of Everett [3usiness License Number (reqw�ed; <br />� � .�j <br />Contrac; Price ot Work <br />TS C`k2rq�1 rso--�+wn..w;�.,v�.�w�.,;.�,•nl <br />Conlact PersonlContact NumberlEmail <br />Descrlptionu(N.brkto�eDone� CGS�L��L�(�l�(�(,7 S•9viN� iLc-j'„����ri�fT�j- 6�= ��C����'4 I <br />`�l l�'n-i N'1 N S � (il l v: l- h- ��) $ . Z C. i1'r tan i I <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I iiercDy certdy fhaf I have iBad 3hd B.raminsd fhis application and kr.o�v fhe same lo be frue and <br />corrt�cL All piovisions ol lavs and ordinonces govemina this fypr ol �.vork wd! be compfeted <br />�vhefher spcci(ied hercin or not The granting of a permit docs not presurnc to give authority (o <br />wola(e or cancel fhe p�ovisions ol any ofher sft+te or local law regu/afing con5truchon or the <br />per/o�mance ol conslruc6on. ihaf I am aufhonzed by fhe ou�nero! fhis property to pedorm fhe <br />�•�ork lor �t•hich application is made and I comply }•�rth tbe Sfate Confracrors Law 18.27 RCW und <br />296 200 4VAC <br />, <br />nc..«p�.,.,.,,, _--__.'_t31 L�_7ti C-�'tA <br />FEE <br />� 5��Q0 <br />PER�11T# <br />E «c�1-13� <br />